DUBOIS MEDICAL CENTER: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- DUBOIS MEDICAL CENTER (EIN 23-7007055)
- Tax period
- 2024-01-01 to 2024-12-31
- Filed
- 2025-07-21
- IRS object ID
- 202542029349300029
- Schema version
- 2024v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-07-21T09:59:35-06:00 | ReturnTs |
| Tax Period End | 2024-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 830239005 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clifford H Moore & Company | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 South Broadway | AddressLine1Txt |
| City | Riverton | CityNm |
| State Abbreviation | WY | StateAbbreviationCd |
| ZIP | 82501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237007055 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DUBOIS MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DUBO | BusinessNameControlTxt |
| Phone | 3074553044 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1203 | AddressLine1Txt |
| City | Dubois | CityNm |
| State Abbreviation | WY | StateAbbreviationCd |
| ZIP | 82513 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Tami Eastman | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 3074553044 | PhoneNum |
| Signature | 2025-07-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Teri-Anne Moore | PreparerPersonNm |
| PTIN | P00184782 | PTIN |
| Phone | 3078569214 | PhoneNum |
| Preparation | 2025-07-01 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | VICKY BLAKEMAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 128 | AddressLine1Txt |
| City | DUBOIS | CityNm |
| State Abbreviation | WY | StateAbbreviationCd |
| ZIP | 82513 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $63,880 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | WY | LegalDomicileStateCd |
| Activity Or Mission | ORGANIZATION BUILT A CLINIC BUILDING TO HOUSE MEDICAL SERVICE PROVIDERS IN A SMALL TOWN TO PROVIDE MEDICAL SERVICES TO RESIDENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $6,065 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,666 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,482 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,423 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$13,714 | PYOtherRevenueAmt |
| CY Other Revenue | -$3,691 | CYOtherRevenueAmt |
| PY Total Revenue | -$6,167 | PYTotalRevenueAmt |
| CY Total Revenue | $5,398 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $22,217 | PYOtherExpensesAmt |
| CY Other Expenses | $18,233 | CYOtherExpensesAmt |
| PY Total Expenses | $22,217 | PYTotalExpensesAmt |
| CY Total Expenses | $18,233 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$28,384 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$12,835 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,467,415 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,472,724 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,238 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $27,382 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,458,177 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,445,342 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE MEDICAL FACILITIES | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $63,747 | ExpenseAmt |
| Revenue | $59,951 | RevenueAmt |
| Desc | THE ORGANIZATION OPERATES A MEDICAL CLINIC BUILDING RECEIVING DONATION | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $12,968 | ExpenseAmt |
| Revenue | $506 | RevenueAmt |
| Desc | THE ORGANIZATION OPERATES A FITNESS AND THERAPY FACILITY AT NO CHARGE | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $76,715 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TAMI EASTMAN | PersonNm |
| Phone | 3074553044 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | BOX 1996 | AddressLine1Txt |
| City | DUBOIS | CityNm |
| State Abbreviation | WY | StateAbbreviationCd |
| ZIP | 82513 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| VICKI BLAKEMAN | |||||||
| PRESIDENT | 2 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| REBECCA SELLNO | |||||||
| SECRETARY | 1 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| TAMI EASTMAN | |||||||
| TREASURER | 1 | 0 | Yes (X) | Yes (X) | $2,833 | $0 | $0 |
| SANDRA LAHR | |||||||
| VICE PRES | 1 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| RICK METZGER | |||||||
| DIRECTOR | 1 | 0 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL PIERLE | |||||||
| DIRECTOR | 1 | 0 | Yes (X) | $0 | $0 | $0 | |
| MARGARET WELLS | |||||||
| DIRECTOR | 1 | 0 | Yes (X) | $0 | $0 | $0 | |
| RICK BRIDGE | |||||||
| DIRECTOR | 1 | 0 | Yes (X) | $0 | $0 | $0 | |
| RANDELL TERRY | |||||||
| DIRECTOR | 1 | 0 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,833 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NONE | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Membership Dues | $160 | MembershipDuesAmt |
| All Other Contributions | $5,506 | AllOtherContributionsAmt |
| Total Contributions | $5,666 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,423 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,423 | RelatedOrExemptFuncIncomeAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $54,791 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $58,482 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$3,691 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,691 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$3,691 | RelatedOrExemptFuncIncomeAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,398 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$268 | RelatedOrExemptFuncIncomeAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,052 | TotalAmt |
| Program Services | $2,833 | ProgramServicesAmt |
| Management And General | $2,219 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $333 | TotalAmt |
| Program Services | $333 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $375 | TotalAmt |
| Program Services | $375 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,019 | TotalAmt |
| Program Services | $3,019 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,355 | TotalAmt |
| Program Services | $9,355 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | TAXES AND LICENSES | Desc |
| Total | $99 | TotalAmt |
| Program Services | $99 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,233 | TotalAmt |
| Program Services | $16,014 | ProgramServicesAmt |
| Management And General | $2,219 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,346 | BOYAmt |
| EOY | $51,763 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,117 | BOYAmt |
| EOY | $125,589 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,237,446 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $942,750 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,347,332 | BOYAmt |
| EOY | $1,294,696 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $620 | BOYAmt |
| EOY | $676 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,467,415 | BOYAmt |
| EOY | $1,472,724 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,238 | BOYAmt |
| EOY | $27,382 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,238 | BOYAmt |
| EOY | $27,382 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,458,177 | BOYAmt |
| EOY | $1,445,342 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,458,177 | BOYAmt |
| EOY | $1,445,342 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,467,415 | BOYAmt |
| EOY | $1,472,724 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$12,835 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $71,861 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $145,030 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,050 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $23,650 | CurrentTaxYearAmt |
| Total | $258,591 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $71,861 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $145,030 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,050 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $23,650 | CurrentTaxYearAmt |
| Total | $258,591 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $258,591 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $43,518 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $48,578 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $45,191 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $49,332 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $58,214 | CurrentTaxYearAmt |
| Total | $244,833 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $503,424 | TotalSupportAmt |
| Public Support CY170 | 0.51370 | PublicSupportCY170Pct |
| Public Support PY170 | 0.71920 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $80,184 | InvestmentCostOrOtherBasisAmt |
| Book Value | $80,184 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,812,700 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $652,187 | DepreciationAmt |
| Book Value | $1,160,513 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $305,696 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $254,453 | DepreciationAmt |
| Book Value | $51,243 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $38,866 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $36,110 | DepreciationAmt |
| Book Value | $2,756 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,294,696 | TotalBookValueLandBuildingsAmt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TAMI EASTMAN | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | TREASURER | RelationshipDescriptionTxt |
| Transaction | $2,833 | TransactionAmt |
| Transaction | ACCOUNTING SVCS | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 990 PART VI LINE 11b | THE BOARD MEMBERS REVIEW FORM 990 BEFORE IT IS FILED. |
| 990 PART VI LINE 19 | THE ORGANIZATIONS DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST |
| 990 PART VIII, LINE 6b | REPAIRS 2752 SNOW REMOVAL 600 DEPRECIATION 55130 TOTAL 58482 |